HomeFormsAcknowledgment of Data Collection and Consent to ShareData Privacy Notice, Acknowledgment, and Consent

1.1. Data Privacy Notice, Acknowledgment, and Consent

This document contains the following components:

Staff Instructions

Client Rights Information

In-Person Acknowledgment of Data Collection and Consent to Share

Verbal Acknowledgment of Data Collection and Consent to Share

Posted Data Privacy Notice

Clients should complete the Acknowledgment of Data Collection and Consent to Share before their information is entered in HMIS. Clients should complete this form yearly. A verbal (over the phone) version is available on Page 4 of this document.

The Posted Data Privacy Notice must be displayed in your agency's client intake area.

Please email feedback, suggestions, or new form requests to hmis@cohhio.org

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5.1. List of HMIS Resources